We have two basic scientists in our group as well as clinician-teachers who lead and participate in clinical research. We have a strong training program for subspecialty residents in Neonatal-Perinatal Medicine.

Approximately 7,000 deliveries per year take place at The Ottawa Hospital (both the General and Civic campuses), which is the regional perinatal centre for Eastern Ontario. Many of these are following high-risk pregnancies, fetal anomalies that may have been detected in utero, and mothers who may have significant medical problems, pregnancy-induced problems or premature labour.

There are over 450 admissions per year to the Neonatal Intensive Care unit (NICU) at The Ottawa Hospital - General Campus (25 level 3 and level 2 beds) with 35 per cent being infants weighing less than 1,500 grams at birth.

The NICU at CHEO (20 Level 3) provides care each year for approximately 400 high-risk infants who are born in the surrounding region of Eastern Ontario and Western Quebec and are brought to CHEO via the neonatal transport team. Our facilities also provide neonatal care for the Baffin Island region of Nunavut.

Babies born in the region with severe medical or surgical conditions are treated at CHEO’s NICU while extremely premature babies are cared for at The Ottawa Hospital - General Campus. Moderately premature babies are treated at the Rich Little Special Care Nursery (SCN) at The Ottawa Hospital - Civic Campus (17 Level 2 beds).

Our multi-disciplinary approach provides the highest standards of care for our smallest patients. Dieticians, pharmacists, respiratory therapists, family social workers and pediatric subspecialists work with the team of neonatologists and nurses that make up our division.

Related links

• Canadian Bioethics Society
• Canadian Paediatric Society
• Canadian Tri-council core skills tutorial for research ethics

Inpatient care 

State of the art NICU practices are delivered to around 60 patients every day. High volume and acuity translate into routine exposure to interventions such as high frequency oscillatory ventilation, nitric oxide, cooling for hypoxic-ischemic encephalopathy (HIE). The catchment area is approximately 15,000 deliveries per year (excluding Western Quebec) and the CHEO neonatal transport team every year brings around 250 babies with various conditions such as sepsis, respiratory distress and complex congenital malformations. 

The busy surgical/cardiac NICU at CHEO provides care to a wide range of pre- and post-operative surgical neonates: general thoracic and abdominal surgery, ENT, neurosurgery, cardiac catheterism and surgery. The division and CHEO subspecialties offer to residents research opportunities in multiple fields including bronchopulmonary dysplasia, metabolic and genetic disorders, perinatal ethics, HIE and stem cell therapy.dysplasia, metabolic and genetic disorders, perinatal ethics, HIE and stem cell therapy.

Outpatient care 

Neonatal follow-up clinic

The Neonatal Follow-up Clinic is run at CHEO and comprehensively follows all infants born at less than 1,250 grams and infants with other risk factors. Patients seen in the clinic have been admitted to one of the neonatal intensive care units in Ottawa or have been referred from another centre. Approximately 500 children are seen every year at the Neonatal Follow-up Clinic. 

Infants are seen at CHEO at four, ten and eighteen months, and again at four years of age. They are screened for motor, cognitive, visual and hearing impairments with early referral to specialists if necessary. 

Antenatal clinic 

The Ottawa Hospital - General Campus currently runs an antenatal consultation clinic every week where women carrying fetuses with special needs are seen before delivery. The clinic provides counselling, education and support to couples and formulates postnatal management plans that take into account the multi-disciplinary needs of the infants. Hospitalized high risk women are also counselled at the time of their admission and on a regular basis until delivery. 

Clinical problems and diseases evaluated and followed:

• Management of extremely pre-term infants born at the boundary of viability
• RDs and BPD: surfactant therapy, non-invasive ventilation, nitric oxide, high frequency oscillation and jet ventilation
• Complex malformations, genetic disorders, inherited metabolic disorders
• Congenital heart disease, congenital diaphragmatic hernia, complex ENT malformation
• Severe brain malformation, neonatal seizures, hypoxic ischemic encephalopathy
• Sepsis, jaundice, electrolytes disorders, disorders of the endocrine and immune system, neonatal abstinence syndrome

Most members of the Division of Neonatology are actively involved in clinical research. Areas of research include:

• Surfactant, bronchopulmonary dysplasia and ventilation
• Stem cell therapy and regenerative medicine
• Neonatal transport and follow-up
• Medical ethics and trainee education
• Database – health service delivery (using large databases such as those housed in Better Outcomes Registry and Network (BORN) and Institute for Clinical and Evaluative Sciences (ICES)
• Neonatal pain management
• Neonatal renal function
• Neonatal jaundice
• Therapeutic hypothermia for neonatal encephalopathy
• Neonatal sepsis and necrotizing enterocolitis (NEC)
• The genetics underlying NEC as well as the impact of different molecules and drugs on the premature gut
• Mechanisms of lung development, injury and repair in order to design new treatments for incurable lung diseases
• Vitamin D in neonates
• PDA management in the premature infant and in rational use of antibiotics in the NICU
• Early determinants of long-term outcomes
• Use of point of care ultrasound including targeted neonatal echocardiography (TNEcho)

Undergraduate training opportunities

Neonatal Intensive Care Unit (NICU)

Objectives

• To gain an understanding of the common diseases affecting newborn infants
• To learn about stabilization and transport of sick neonates
• To learn about the facilities and resources available to treat sick neonates
• To understand the challenges for infants who graduate from the NICU

Elective students will work with a multi-disciplinary team including an attending neonatologist, neonatal fellows, pediatric residents, nurses, a dietician, pharmacist and social worker. Students will assist in the complex care of premature infants as well as full-term infants with issues such as perinatal asphyxia, jaundice, neonatal sepsis, congenital heart disease or major congenital malformations requiring surgical repair.

In addition, the student has the option to participate in the neonatal transport program providing for the stabilization and transfer of high-risk infants from the hospital of birth to CHEO’s NICU.

Attendance at the multi-disciplinary Neonatal Follow-up Clinic to monitor the development of high-risk NICU patients is also possible. Pre-clinical students are welcome to join daily patient care rounds to observe the many critical aspects involved in comprehensive neonatal intensive care or to participate in the multi-disciplinary assessment of infants at greatest risk of neuro-developmental handicap in the Neonatal Follow-up Clinic. Students of any year may choose a major topic to study in-depth under the supervision of the neonatologist.

Neonatal / Perinatal medicine

Objectives

• To gain insight into normal and abnormal fetal development
• To learn about the transition from the intrauterine to extrauterine environment
• To learn about the disease processes in newborn infants
• To explore ethical principles involved in neonatal intensive care

During this elective, students will participate in a variety of rounds and seminars discussing the optimal care for high-risk pregnancies. They will work with a multi-disciplinary team consisting of an attending neonatologist, neonatal fellows, pediatric and obstetrics residents, nurses, a dietician, pharmacist, and social worker to assist with the ongoing care of sick preterm and term newborns. They will have opportunities to attend high-risk deliveries of preterm and term infants and may also get a chance to attend a Neonatal Follow up Clinic at CHEO.

This elective is suitable for students of any year with pre-clinical students taking primarily an observer’s role and clinical students having more direct involvement with patient care. For all years, the basic physiology and pathophysiology of the clinical situations will be stressed.

Postgraduate training program

The uOttawa Faculty of Medicine program in Neonatal-Perinatal Medicine is a two- to three-year residency training program designed to train academic neonatologists. Trainees wishing to complete one to two years of training for a non-academic role can be considered for admission to the program.

The program is open for the Royal College of Physicians and Surgeons subspecialty certification to trainees who have a Royal College Certification in pediatrics or have completed at least three years of a Royal College approved training program in pediatrics.

Clinical fellows may also be accepted to the program for one or more years to gain additional training in neonatal-perinatal medicine.

Clinical training takes place in the Neonatal Intensive Care Unit (NICU) of the Children’s Hospital of Eastern Ontario (CHEO) and in the Neonatal-Perinatal Unit of The Ottawa Hospital - General Campus, which is the regional perinatal centre. These two hospitals are connected by an aerial walkway that passes through the buildings housing the Faculties of Medicine and Health Sciences, the CHEO Research Institute and the Centre for Practice Changing Research (CPCR). There are approximately 15,000 live births annually in Eastern Ontario (excluding Western Quebec). Our facilities also provide neonatal care for the Baffin Island region of Nunavut. 

See full details of the program at the Division of Neonatology Postgraduate Program

Additional postgraduate training

Some members of the Division of Neonatology are affiliated with basic sciences or epidemiology departments at the University of Ottawa, providing opportunities for co-supervision of trainees at the Master’s or PhD level.